1102 SHUKSAN WAY BRIOTECH 2025-01-13

Bl DING PERMIT APPLICAT N CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P)425-257-8810 1 (E)PermitServices@everettwa.gov 1 (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1102 Shuksan Way PARCEL#: 28040100302200 clTy Everett STATE WA Zip 98203 SUITE/UNIT#: 1 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): BrioteCh LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:JSH Properties OWNER MAILING ADDRESS: STREET 305 108th Ave NE, Unit 101 c,T, Bellevue STATE WA Zip 98004 OWNER PHONE: 425-455-0500 1OWNER EMAIL: nlCk@briotechusa.com CONTRACTOR COMPANY NAME: Northwest Handling Systems WA STATE CONTRACTOR LICENSE#(REQUIRED): CC NORTHWH275JF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 011598 CONTRACTOR ADDRESS: STREET 11 OO SW 7th St CITY Renton STATE WA zip 98057 CONTRACTOR PHONE: 425-91 9-3597 CONTRACTOR EMAIL: nellm@nWhS.Com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-91 9-3597 Neil Montague CONTACT EMAIL: nellm@nwhS.COM BUILDING INFORMATION VALUATION OF WORK:$ 75,850.00 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: Warehouse PROPOSED USE OF BUILDING: Warehouse HEAT SOURCE: ❑✓Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑✓T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Install (63) bays of Selective & Pushback pallet racking R ECEOVE J U L 0 9 2024 pp��//R� TT ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and correct. Work done p49sfgl ki499 Hf1li omp/y with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official ore ing authorized under any circumstance.I am the owner, or I am authorized by the owner of this property to perform the work for which application is made, and/comply the tate Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# r _ Owner/Authorized Agent Signature Date (Revised 412112022)